Updated 12:17 pm, Thursday, September 12, 2013

The fire department will be devoting the next six to 12 months to determine the most efficient way to implement an ambulance service based on recommendations from a private consultant, Sugar Land spokesman Doug Adolph said.

"The next chapter will be diving into our emergency call load," he said.

The move to a city-operated ambulance service was sparked by Sugar Land's medical director, Dr. Joe Anzaldua.

The goal, Adolph said, is an eight-minute response time for 90 percent of all Advanced Life Support calls.

Advanced Life Support calls, combined with 60 seconds of communication with a dispatcher and 60 seconds to get responders into a running vehicle, should total 10 minutes from an emergency call being made to help arriving on the scene.

"We've been working with the county for over a year to see if those standards could be met, and we came to the conclusion it would best if we did it ourselves," said Adolph, adding that Sugar Land has been unable to obtain complete data on county response times within the city.

Providing EMS service to one of the fastest growing counties in Texas has many challenges, said Melanie J. Manville, spokeswoman for the county ambulance service.

" One challenge is to ensure that response times fall within the goals of the department," she said.

Fort Bend County EMS has two units located within the city limits of Sugar Land, Manville said.

One unit is on Williams Trace near U.S. 59 and the second is located at the city's Fire Station No. 2 at 1040 Industrial.

"The additional EMS resources which will be added by the city of Sugar Land will not only benefit the city, but the rest of the county as well," Manville said.

She explained the county's resources located within Sugar Land will be reallocated to other parts of the county where call volumes have increased.

"Placing county resources closer to these high-call volume areas will help reduce the county overall response time," Manville said.

The recommendation to add ambulance services to the Sugar Land Fire Department came from TriData, a division of Virginia-based System Planning Corp. The consulting firm, which specializes in fire, EMS and emergency preparedness was hired by the Sugar Land Fire Department last year.

To implement ambulance services, TriData has recommended that the fire department hire 11 new paramedic/firefighters, two EMS dispatchers and an EMS battalion chief. The role of the city medical director would be expanded, and firefighters would be provided EMS training.

The department also would acquire three ambulances.

Sugar Land's proposed budget for fiscal year 2014 includes approximately $689,000 for start-up EMS expenses.

In addition to the ambulance service, Anzaldua has called for the creation of a patient care reporting system that would allow paramedics in the field to get patient information to hospitals before the patients arrive.

"It would allow for a seamless transfer of care," Adolph said.

TriData has made additional recommendations, too, including the creation of an emergency medical dispatch system or protocol that would help dispatchers identify both critical and minor emergency calls and send appropriate personnel and equipment.

Emergency calls in Sugar Land go first to the city's dispatch center, which handles fire and police calls.

Emergency medical service calls are forwarded to Fort Bend County, which then dispatches an ambulance.

Sugar Land sends a fire truck to these calls as well. The city and county each have Advanced Life Support equipment.

"We've relied on the county, and their service area is very large," Adolph said. "The advantage we have in Sugar Land is we have strategically placed fire stations in our city that enable us to put out the right resources for the call."

"While the Sugar Land Professional Firefighters Association is in favor of upgrading EMS services to the citizens, we feel that there are several issues regarding the current implementation plan or lack of one," the association's letter says.

The association is asking the fire department to establish a final implementation plan before approving its next budget.

"Our major concern is that they maintain two paramedics on each ambulance for Advanced Life Support calls," said Keith Mensik, the association's secretary/treasurer.

"Personnel deployed to ALS emergency responses shall include a minimum of two members trained at the emergency medical technician-paramedic level and two members trained at the emergency medical technician-basic level arriving on scene within the established travel time."

The Sugar Land association is concerned with the plan to staff the city ambulances with one firefighter/paramedic and one firefighter/basic or intermediate.

"Not every fire apparatus will have an intermediate or paramedic," the association letter says. "There will be times when we will not be able to meet the standard of two paramedics and two basics for ALS calls because we only will be sending one. We need to maintain ALS care on our fire apparatus to continue to provide the best care and meet national standards for response.

"Currently, when someone calls 911 for an EMS call they get a mobile intensive care unit ambulance from Fort Bend County with two paramedics and an ALS fire apparatus from Sugar Land with three or four personnel," the letter adds.

"Fort Bend County also has an EMS supervisor available 24/7. Sugar Land will not have an EMS supervisor available for emergency response. Sugar Land has not committed to the Medical Intensive Care Unit format. They continue to say ALS response."

Additional association concerns involve the Sugar Land Fire Department's ability to meet national standards for response times under the proposed ambulance plan and the likelihood of the fire department realizing TriData's projected revenues for ambulance service: $975,000 in the first year.

Mensik said the firefighters' association has not had an opportunity to meet with fire department officials yet about its concerns.

"Communication has come to a standstill," he said.

Adolph said the fire department will work with the association on its concerns.